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AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for AARP Medicare Advantage from UHC NC-0011 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on AARP Medicare Advantage from UHC NC-0011 (HMO-POS) in 2026, please refer to our full plan details page.
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) is a HMO-POS plan offered by UnitedHealth Group, Inc. available for enrollment in 2025 to people living in Select Counties in North Carolina. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that AARP Medicare Advantage from UHC NC-0011 (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about AARP Medicare Advantage from UHC NC-0011 (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For AARP Medicare Advantage from UHC NC-0011 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $520.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6700.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The AARP Medicare Advantage from UHC NC-0011 (HMO-POS) plan features an annual drug deductible of $520. For Tier 1 preferred generic drugs, you will pay no copay at standard pharmacies and through mail order services. Tier 2 generic drugs cost a $10 copay for a one-month supply at standard pharmacies, but you can get a three-month supply with no copay using preferred mail order. For brand-name and specialty medications, the plan uses coinsurance instead of flat copays. Tier 3 preferred brand drugs require a 15% coinsurance, while Tier 4 non-preferred drugs carry a 37% coinsurance. Tier 5 specialty tier drugs have a 27% coinsurance for a one-month supply across standard pharmacies and mail order options.
Additional Benefits
The AARP Medicare Advantage from UHC NC-0011 (HMO-POS) plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, telehealth, and annual preventive physicals. For specialist visits, copays range from no copay to $45, while inpatient hospital stays require a $550 daily copay for the first few days before transitioning to no copay. Emergency room visits carry a $130 copay, which is waived upon admission, and worldwide emergency services are fully covered with no copay or coinsurance. This plan also includes valuable supplemental benefits, such as routine dental exams, cleanings, and annual eye and hearing exams with no copay and no coinsurance. Vision benefits feature a $150 eyewear allowance every two years, while hearing aid coverage requires copays ranging from $199 to $1,249 with no coinsurance. Additionally, members benefit from home health services, over-the-counter items, and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, though prior authorization is required. For acute stays, there is a $550 daily copay for days 1-5 and no copay for days 6 and beyond, while psychiatric stays require a $550 daily copay for days 1-4 and no copay for days 5-90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $550, observation services carry a $550 daily copay, and outpatient substance abuse sessions have a copay ranging from $0 to $25, all with no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by AARP Medicare Advantage from UHC NC-0011 (HMO-POS) with a $55.00 copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) covers ground and air ambulance services with a $275 copay and no coinsurance, though prior authorization is required. While some transportation services are covered, transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a copay of $0 to $50 with no coinsurance, while worldwide emergency, urgent care, and emergency transportation services are covered with no copay and no coinsurance.
Primary Care See details
Primary care benefits are partially covered by AARP Medicare Advantage from UHC NC-0011 (HMO-POS), as routine chiropractic care and other chiropractic services are not covered. Covered services feature no coinsurance, offering no copay for primary care, telehealth, and opioid treatment, and copays ranging from $0 to $45 for specialist visits, therapies, podiatry, and mental health sessions.
Preventive Services See details
Preventive services are partially covered by AARP Medicare Advantage from UHC NC-0011 (HMO-POS) with no copay and no coinsurance for annual physical exams, fitness benefits, home safety devices, kidney education, and select screenings. Sub-services that are not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, smoking cessation, disease management, telemonitoring, remote access, and counseling.
Hearing Services See details
Hearing services are partially covered by AARP Medicare Advantage from UHC NC-0011 (HMO-POS), which provides one routine hearing exam annually with no copay and no coinsurance. Covered prescription hearing aids carry a $199.00 to $1,249.00 copay and no coinsurance, while OTC hearing aids have a $199.00 to $829.00 copay and no coinsurance. Hearing aid fitting and evaluation exams, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) offers partially covered vision services with no copay and no coinsurance for annual routine eye exams and select eyewear, up to a $150 allowance every two years. While contact lenses, eyeglass frames, and eyeglass lenses (with a $0 to $153 copay) are covered, other eye exam services, combined eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) partially covers dental services, offering preventive care like exams, cleanings, and X-rays with no copay and no coinsurance. Medicare-covered dental services require no copay and a 20% coinsurance, while restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by AARP Medicare Advantage from UHC NC-0011 (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from no coinsurance to 20%, while Part B insulin has a $35 copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and a 20% coinsurance. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) covers diagnostic services with no coinsurance, featuring a $50 copay for tests and no copay for lab services. Covered radiological services require prior authorization and include diagnostic radiology with no copay, outpatient X-rays for a $30 copay with coinsurance, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the AARP Medicare Advantage from UHC NC-0011 (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under the AARP Medicare Advantage from UHC NC-0011 (HMO-POS) plan, although in practice only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
AARP Medicare Advantage from UHC NC-0011 (HMO-POS) provides partial coverage for other services, offering over-the-counter (OTC) items and chronic illness meal benefits with no copay and no coinsurance. Acupuncture is not covered under this benefit, and the meal benefit requires prior authorization.
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